New Hampshire is aiming to reduce the wait for emergency psychiatric admissions to the state hospital.
Patients are now enduring waits as long as several days.
“It is unacceptable for someone experiencing a psychiatric crisis to have to wait this long for critical inpatient care, for both the individual as well as their concerned family members,” said Nicholas Toumpas, Health and Human Services Commissioner in announcing the plan yesterday.
The delays affect communities, too, because advocates say those experiencing mental health crises end up stuck in hospital emergency rooms, in trouble with the law or they simply stop trying to get help.
“It’s wrong medically, legally, ethically and morally. We don’t do this with any other medical condition,” said Ken Norton, executive director of the National Alliance for the Mentally Ill - New Hampshire .
Toumpas blamed budget reductions, the closure of local psychiatric units and the loss of 60 beds at the state hospital since 2009 for the waiting list.
The issue came up in Salem last month when Deputy police Chief Shawn Patten blamed the state’s mental health system for failing a man police have dealt with repeatedly over many years.
“We’ve had over 40 contacts with him over eight to 10 years,” Patten said at the time. “In our opinion, the mental health system in the state of New Hampshire is failing him.”
And with that failure, he said, comes a great physical risk to the man’s family, police officers and the community.
“This is eventually going to have tragic consequences if this isn’t dealt with,” he said last month. “We’re in fear for his family, his friends, the safety of our officers who have to respond to these calls on a regular basis.”
In response, Dr. Robert MacLeod, the CEO of New Hampshire Hospital, said times have changed.
“We’re truly an acute care, short-stay institution,” he said last month. “The days of institutions keeping people indefinitely are over.”
Yesterday, Toumpas said the Department Health and Human Services will be seeking more money in the state budget to help alleviate the problem, but, in the meantime, announced intermediate steps to reduce the wait.
These include daily tracking of people awaiting a bed at the state hospital, using psychiatric staff to help emergency room physicians in managing behavioral crises, providing better community follow-up and temporarily reopening 12 beds at the state hospital.
“Let me be clear, we cannot do this on our own,” Toumpas said. “This is a very complex subject and involves the coordination of many partners.”
He is looking for support from community mental health centers, NAMI-NH, law enforcement, local hospitals and others.
The New Hampshire Community Behavioral Health Association said the announcement acknowledges the problem, but isn’t a permanent solution.
The association’s president, Jay Couture, said until the state invests in community-based services, “there will continue to be places where people who are seriously ill will fall through the cracks and not receive timely, appropriate care.”
Victor Topo, executive director for the the Center for Life Management in Derry, one of the state supported regional mental health centers, said the remedial effort by DHHS is welcome and hopefully will lead to a more permanent solution.
“This has been a significant issue, no question about it,” Topo said. “I know for a fact patients have been stuck for days.”
That’s the case for centers throughout the state, and for both adults and juveniles seeking mental health care, he said.
Norton said advocates and health care organizations will have more to say next month when they push for better state funding for mental health services.
“We particularly want to highlight this issue,” he said.
Topo agreed there needs to be an injection of more state funding into community services.
Norton characterized the situation as complex. He said New Hampshire has gone from the top-ranked state for mental health care in the 1990s, a model for community-based services, to a situation where federal regulators and advocates are pressing in court for the state to do better.
“Now, we’re not doing real well,” Norton said.
The waiting list for state hospital admission can discourage people from getting the help they need, he said.
“It’s so important for people to get help,” he said.